<form id="form" action="<?php echo site_url(array('tecnico','insertar'));?>" method="post">
	<table class="form-table">
		<tr>
			<td><label>Nombre:</label></td>
			<td>
				<input maxlength="25" size="25" name="nombres" value="<?php echo post_value('nombres');?>"/>
			</td>	
		</tr> 
		<tr>
			<td><label>Password:</label></td>
			<td>
				<input type="password" maxlength="25" size="25" name="password"/>
			</td>			
		</tr>	
		<tr>
			<td><label>Repita Password:</label></td>
			<td>
				<input type="password" maxlength="25" size="25" name="cpassword"/>
			</td>
		</tr>
		<tr>
			<td><label>Email:</label></td>
			<td>
				<input maxlength="35" size="25" name="email" value="<?php echo post_value('email');?>"/>
			</td>	
		</tr>
		<tr>
			<td><label>Apellido:</label></td>
			<td>
				<input maxlength="35" size="25" name="apellidos" value="<?php echo post_value('apellidos');?>"/>	
			</td>	
		</tr>
		<tr>
			<td><label>Documento:</label></td>
			<td>
				<input maxlength="35" size="25" name="documento" value="<?php echo post_value('documento');?>"/>		
			</td>	
		</tr>
		<tr>
		   	<td><label>Pais</label></td>
		   	<td>
				<select name="pais_fk" style="width: 200px;">
				  	<option value="1">URUGUAY</option>  
				</select>
			</td>			    		
		</tr>
		<tr>
		   	<td><label>Departamento</label></td>
		   	<td>
				<select name="departamento_fk" style="width: 200px;">
				  	<option value="1">MONTEVIDEO</option>
				  	<option value="2">CANELONES</option>
				  	<option value="3">MALDONADO</option>
				  	<option value="4">ROCHA</option>
				  	<option value="5">TREINTA Y TRES</option>
				  	<option value="6">CERRO LARGO</option>
				  	<option value="7">RIVERA</option>
				  	<option value="8">SALTO</option>
				  	<option value="9">ARTIGAS</option>
				  	<option value="10">PAYSANDU</option>
				  	<option value="11">SORIANO</option>
				  	<option value="12">RIO NEGRO</option>
				  	<option value="13">SAN JOSE</option>
				  	<option value="14">COLONIA</option>
				  	<option value="15">FLORES</option>
				  	<option value="16">FLORIDA</option>
				  	<option value="17">LAVALLEJA</option>
				  	<option value="18">DURAZNO</option>
				  	<option value="19">TACUAREMBO</option> 
				</select>
			</td>			    		
		</tr>
		<tr>
			<td><label>Barrio:</label></td>
			<td>
				<input maxlength="35" size="25" name="barrio" value="<?php echo post_value('barrio');?>"/>
			</td>	
		</tr>
		<tr>
			<td><label>Direccion:</label></td>
			<td>
				<input maxlength="35" size="25" name="direccion" value="<?php echo post_value('direccion');?>"/>
			</td>	
		</tr>
		<tr>
			<td><label>Celular:</label></td>
			<td>
				<input maxlength="35" size="25" name="celular" value="<?php echo post_value('celular');?>"/>
			</td>	
		</tr>
		<tr>
			<td><label>Coordenadas:</label></td>
			<td>
				<input maxlength="35" size="25" name="coordenadas" value="<?php echo post_value('coordenadas');?>"/>
			</td>	
		</tr>
	</table>
	
	<table class=grid-table>
	<thead>
		<tr>
			<th>Ingresar los Servicios</th>
			<th></th>
		</tr>
	</thead>
	<tbody>		
		<?php foreach($tipos_servicio as $lista_s):?>
			<tr>
				<td><?php echo $lista_s['nombre'];?></td>
				<td><input type="checkbox" name="chk_group[]" value="<?php echo $lista_s['id'];?>" > </td>
			</tr>
		<?php endforeach;?>
	</tbody>
	</table>
	
	<input type="submit" value="Confirmar"/>
	<a class="button-volver" href="<?php echo site_url(array('tecnico','cancelar'));?>"><input type="button" name="cancel" value="Cancelar" /></a>
	
	
</form>